Planning for the Future: The Role of Nurse Practitioners and Physician Assistants in Survivorship Care

2012 ◽  
pp. e56-e61 ◽  
Author(s):  
Mary S. McCabe ◽  
Todd Alan Pickard
Keyword(s):  
Nurse Practitioners ◽  
Supply And Demand ◽  
Physician Assistants ◽  
The United States ◽  
Health Care Team ◽  
True Value ◽  
Shortage Of Physicians ◽  
Patients At Risk ◽  
Increase In Productivity

Overview: The number of cancer survivors in the United States now approaches 12 million individuals, with an estimated 7.2% of the general population aged 18 years or older reporting a previous cancer diagnosis. These figures highlight a number of questions about the care of survivors—how patients at risk for a known set of health problems should be followed, by whom, and for how long. At the same time that oncologists are developing strategies to provide services to this growing population, there are economic and systems challenges that have relevance to the previous questions, including a predicted national shortage of physicians to provide oncology services. Nurse practitioners (NPs) and physician assistants (PAs) have been identified as members of the health care team who can help reduce the oncology supply and demand gap in a number of ways. The ASCO Study of Collaborative Practice Arrangements (SCPA) in 2011 concluded that oncology patients were aware and satisfied when their care was provided by NPs and PAs; there was an increase in productivity in practices that utilized NPs and PAs; utilizing the full scope of practice of NPs and PAs was financially advantageous; and, physicians, NPs, and PAs are highly satisfied with their collaborative practices. Increasingly, the oncology and health policy literature contains evidence supporting innovative provider models. There is still much work to be done to move beyond pilot data to establish the true value of these models.

scholarly journals Understanding the role of nurse practitioners, physician assistants and other nursing staff in HIV pre-exposure prophylaxis care in the United States: a systematic review and meta-analysis

BMC Nursing ◽  
2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Chen Zhang ◽  
Warton Mitchell ◽  
Ying Xue ◽  
Natalie LeBlanc ◽  
Yu Liu
Keyword(s):  
United States ◽  
Study Design ◽  
Nurse Practitioners ◽  
Nursing Staff ◽  
Physician Assistants ◽  
The United States ◽  
Health Providers ◽  
Physician Health ◽  
Exposure Prophylaxis

Abstract Background Although pre-exposure prophylaxis (PrEP) was approved for primary HIV prevention by the Federal Drug Administration in 2012, PrEP utilization has been suboptimal. A body of literature and programs has emerged to examine the role of nurse practitioners (NPs), physician assistants and nursing staff in PrEP care. This review aims to understand the current status of non-physician health providers in PrEP care implementation in the United States. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance, we conducted a comprehensive literature search using multiple databases to identify peer-reviewed articles that examined the role of non-physician health providers in the implementation of PrEP. Four major databases of studies using observational study design, randomized control trials and mixed-method study design were screened from November 2019 to January 2020 were searched. Two independent reviewers examined eligibility and conducted data extraction. We employed random-effects model aims to capture variances of estimates across studies. Results A total of 26 studies with 15,789 health professionals, including NPs (18, 95% CI = 14,24%), physician assistants (6, 95% CI = 2, 10%), nursing staff (26, 95% CI = 18–34%), and physicians (62,95% CI = 45, 75%), were included in the analysis. The odds of prescribing PrEP to patients among NPs were 40% (OR = 1.40, 95% CI = 1.02,1.92) higher than that among physicians, while the likelihood of being willing to prescribe PrEP was similar. On the other hand, the odds of being aware of PrEP (OR = 0.63, 95% CI = 0.46, 0.87) was 37% less in nursing professionals than that among physicians. Conclusions Although the limited number and scope of existing studies constrained the generalizability of our findings, the pattern of PrEP care implementation among non-physician health providers was described. To achieve wider PrEP care implementation in the U.S., increasing awareness of PrEP among all health providers including both physicians and non-physicians is a key step.

scholarly journals Team Focus: Physical Therapist

2008 ◽  
Vol 10 (4) ◽  
pp. 127-132 ◽  
Author(s):  
Matthew H. Sutliff
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Neurological Disease ◽  
Physical Therapist ◽  
Occupational Therapists ◽  
Physician Assistants ◽  
Health Care Team

Multiple sclerosis (MS) is a complex neurological disease that requires comprehensive multidiscipli-nary care to maximize patient outcomes. A multidisciplinary health care team treating MS patients often consists of neurologists, physiatrists, nurses, physician assistants or nurse practitioners, and physical and occupational therapists, many of whom are specialists in MS. This article clarifies the role of the physical therapist in the care of patients within a multidisciplinary MS clinic.

scholarly journals Advanced Practitioners as Allies and Advocates

2021 ◽  
Vol 12 (7) ◽  
Author(s):  
Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN
Keyword(s):  
United States ◽  
Health Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
The United States ◽  
Health Care Team ◽  
Care Team ◽  
National Commission ◽  
Clinical Nurse ◽  
Clinical Nurse Specialists

Advanced practitioners (APs) are a growing proportion of the health-care team. As of 2019, there were approximately 325,000 nurse practitioners, 7,000 clinical nurse specialists, and nearly 140,000 physician assistants in the United States (American Academy of Nurse Practitioners, 2021; National Association of Clinical Nurse Specialists, 2020; National Commission on Certification of Physician Assistants, 2019). Although this totals up to 500,000, it is hard to say how many of these APs focus their practice on hematology/oncology, as certification is not required, which is a major method to track these data. Pharmacists are also integral members of the health-care team. As of April 2021, there were 3,600 board-certified oncology pharmacists (BCOP), although this underestimates the number of pharmacists who practice in hematology and oncology who are not BCOP certified (Board of Pharmacy Specialties, 2021).

Response to Dr Stone

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 850-851
Author(s):  
Howard A. Pearson
Keyword(s):  
Nurse Practitioners ◽  
Cost Effective ◽  
The United States ◽  
Health Maintenance Organizations ◽  
Quality Health Care ◽  
Quality Cost ◽  
Health Maintenance ◽  
Effective Care ◽  
Quality Health

Dr Elsa Stone, in her usual organized and lucid fashion, has presented the case for inclusion of pediatric nurse practitioners (PNPs) in private pediatric practices. She bases her conclusions on her nearly 10 years of positive experience with a PNP in her own practice in Connecticut. Dr Stone describes the PNP population and demography, describes the training curriculum of PNPs, and discusses the scope of work of these individuals. She concludes that "there is substantial evidence that PNPs provide quality health care and that collaborative teams of pediatricians and PNPs can provide high-quality, cost-effective care to a broader spectrum of children than can be served by either profession alone." The American Academy of Pediatrics (AAP) has insisted for several years that there is a shortage of pediatricians to meet the expanding needs of the children of the United States. Furthermore, pediatricians—because of system changes—will be expected increasingly to provide a variety of time-intensive services. Dr Stone believes that many of these services can be well provided by PNPs. Within the AAP, there have been some concerns about the role of PNPs. Of particular worry seems to be the possibility that PNPs might decide to practice independently, leading to a lower quality of care for their patients. Less often stated, but clearly an issue, is that PNPs are viewed by some pediatricians as potential competitors. Dr Stone's demographic analysis of what PNPs are currently doing is relevant to these concerns. One third of PNPs work in private pediatric practices or health maintenance organizations.

Clinical Oncology Practice 2015: Preparing for the Future

2015 ◽  
pp. e622-e627 ◽  
Author(s):  
Michael P. Kosty ◽  
Anupama Kurup Acheson ◽  
Eric D. Tetzlaff
Keyword(s):  
Clinical Oncology ◽  
Nurse Practitioners ◽  
Cancer Care ◽  
Medical Knowledge ◽  
Physician Assistants ◽  
The United States ◽  
Practice Model ◽  
American Society ◽  
Oncology Practice

The clinical practice of oncology has become increasingly complex. An explosion of medical knowledge, increased demands on provider time, and involved patients have changed the way many oncologists practice. What was an acceptable practice model in the past may now be relatively inefficient. This review covers three areas that address these changes. The American Society of Clinical Oncology (ASCO) National Oncology Census defines who the U.S. oncology community is, and their perceptions of how practice patterns may be changing. The National Cancer Institute (NCI)-ASCO Teams in Cancer Care Project explores how best to employ team science to improve the efficiency and quality of cancer care in the United States. Finally, how physician assistants (PAs) and nurse practitioners (NPs) might be best integrated into team-based care in oncology and the barriers to integration are reviewed.

Organization and Structure of the Cardiothoracic Intensive Care Unit

2015 ◽  
pp. 86-104
Author(s):  
Michael H. Wall
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Cost Of Care ◽  
Team Members ◽  
Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

Organization and Structure of the Cardiothoracic Intensive Care Unit

Oncology ◽  
2017 ◽  
pp. 709-727
Author(s):  
Michael H. Wall
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Cost Of Care ◽  
Team Members ◽  
Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

Practice Model for Advanced Practice Providers in Oncology

2017 ◽  
pp. 40-43
Author(s):  
Jamie Cairo ◽  
Mary Ann Muzi ◽  
Deanna Ficke ◽  
Shaunta Ford-Pierce ◽  
Katrina Goetzke ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Professional Growth ◽  
Physician Assistants ◽  
Advanced Practice ◽  
Quality Improvements ◽  
Collaborative Relationships ◽  
Practice Model ◽  
Patients With Cancer

According to ASCO, the number of practicing oncologists has remained stable despite growth demands, leading to an overall shortage in many areas of the country. Nurse practitioners and physician assistants are advanced practice providers (APPs) who can assist in the provision of support and care to patients with cancer, but the role of the APP in the oncology setting has not been well defined. There exists a variety of different practice patterns for APPs who work in oncology, and the lack of role definition and absence of an established practice model are considered leading causes of APP attrition. According to the American Academy of Nurse Practitioners, it has been well demonstrated that, when nurse practitioners are allowed to work to the full scope of their education and preparation, there are notable cost reductions and quality improvements in patient care. The focus of APP education and training is on health promotion, disease prevention, and primary care medical management, but most APPs have limited exposure to management of cancer in patients. With this in mind, Aurora Cancer Care developed a practice model for APPs who work in oncology. The goal of the model is to enhance the quality of care delivered to patients and provide a stimulating work environment that fosters excellent collaborative relationships with oncologist colleagues, supports professional growth, and allows APPs to practice to the full extent of their licensure.

Aged care nurse practitioners in Australia: evidence for the development of their role

2013 ◽  
Vol 37 (5) ◽  
pp. 594 ◽  
Author(s):  
Shannon Clark ◽  
Rhian Parker ◽  
Brenton Prosser ◽  
Rachel Davey
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
The United States ◽  
Aged Care ◽  
Service Planning ◽  
Current Evidence ◽  
Ageing Population ◽  
Healthcare Outcomes ◽  
The Impact

Aim To consider evidence surrounding the emerging role of nurse practitioners in Australia with a particular focus on the provision of healthcare to older people. Methods Methods used included keyword, electronic database and bibliographic searches of international literature, as well as review of prominent policy reports in relation to aged care and advanced nursing roles. Results This paper reports on evidence from systematic reviews and international studies that show that nurse practitioners improve healthcare outcomes, particularly for hard to service populations. It also maps out the limited Australian evidence on the impact of nurse practitioners’ care in aged care settings. Conclusions If Australia is to meet the health needs of its ageing population, more evidence on the effectiveness, economic viability and sustainability of models of care, including those utilising nurse practitioners, is required. What is known about the topic? Australia, like many industrialised countries, faces unprecedented challenges in the provision of health services to an ageing population. Attempts to respond to these challenges have resulted in changing models of healthcare and shifting professional boundaries, including the development of advance practice roles for nurses. One such role is that of the nurse practitioner. There is international evidence that nurse practitioners provide high-quality healthcare. Despite being established in the United States for nearly 50 years, nurse practitioners are a relatively recent addition to the Australian health workforce. What does this paper add? This paper positions a current Australian evaluation of nurse practitioners in aged care against the background of the development of the role of nurse practitioners internationally, evidence for the effectiveness of the role, and evidence for nurse practitioners in aged care. Recent legislative changes in Australia now mean that private nurse practitioner roles can be fully implemented and hence evaluated. In the face of the increasing demands of an ageing population, the paper highlights limitations in current Australian evidence for nurse practitioners in aged care and identifies the importance of a national evaluation to begin to address these limitations. What are the implications for practitioners? The success of future healthcare planning and policy depends on implementing effective initiatives to address the needs of older Australians. Mapping the terrain of contemporary evidence for nurse practitioners highlights the need for more research into nurse practitioner roles and their effectiveness across Australia. Understanding the boundaries and limitations to current evidence is relevant for all involved with health service planning and delivery.

Sign in / Sign up

Export Citation Format

Share Document